Carpal tunnel syndrome happens when the median nerve is compressed as it passes through the wrist and into the palm of the hand. This can cause tingling and a pins-and-needles feeling in the thumb, ring finger, index finger, or middle finger.
Symptoms of carpal tunnel syndrome usually get worse over time and are often more noticeable at night. It is more common in people who make repetitive hand movements every day, but it can also develop after fractures in the area or with chronic conditions such as diabetes and autoimmune disorders.
Treatment for carpal tunnel syndrome may include pain relievers, anti-inflammatory medications, physical therapy, and, in some cases, surgery. Depending on the severity, surgery may be needed for symptoms to go away completely.
Common symptoms
The main symptoms of carpal tunnel syndrome are:
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Tingling or a prickling sensation in the hand
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Swollen hands or fingers
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Numbness in the fingers
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A burning sensation or tingling in the forearm (in some cases)
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Weakness and difficulty holding objects
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Wrist pain, especially at night
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Difficulty telling hot from cold
According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases, symptoms often begin at night in one or both hands and may include numbness, weakness, or tingling in the fingers.
If these symptoms appear, it is recommended to see a healthcare provider for an evaluation and to start the most appropriate treatment.
Confirming a diagnosis
Carpal tunnel syndrome may be diagnosed by a primary care provider, orthopedic specialist, or neurologist based on the person’s symptoms and a physical exam, in which the wrist is moved in specific ways to check for pain and how intense it is.
To confirm the diagnosis, the doctor may also order tests such as a wrist X-ray, ultrasound, or electroneuromyography to assess possible damage to the peripheral nerves.
Possible causes
Carpal tunnel syndrome is caused by compression of the median nerve as it passes through the wrist and supplies the palm of the hand.
Risk factors for developing carpal tunnel syndrome include:
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Anatomical changes in the carpal tunnel
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Repetitive hand or wrist movements
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Wrist fractures or dislocation
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Obesity
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Diabetes
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Menopause
In addition, thyroid dysfunction, fluid retention, lymphedema, kidney disease, high blood pressure, or the use of medications such as anastrozole may also increase the risk of carpal tunnel syndrome.
Treatment options
Treatment for carpal tunnel syndrome should be guided by a healthcare professional experienced in this condition, such as a primary care provider, orthopedic or hand surgeon, or neurologist, depending on the person’s symptoms and needs.
The goal is to reduce pressure on the nerve and decrease inflammation, which helps relieve pain and discomfort.
The main carpal tunnel syndrome treatments are:
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Rest, with avoidance of movements that put extra strain on the wrist.
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A wrist splint, which is an orthopedic brace used to keep the wrist still and can also be worn at night to help reduce tingling and pain.
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Pain relievers or anti-inflammatory medications, such as ibuprofen or acetaminophen, to help relieve pain.
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Physical therapy, with exercises that help reduce inflammation and ease compression of the median nerve.
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Corticosteroid injections, given by a doctor into the carpal tunnel area to reduce swelling and pressure on the median nerve.
When carpal tunnel syndrome is caused by another condition, such as rheumatoid arthritis, it is important to also treat the underlying condition so that symptoms can fully improve.
Nonsurgical treatments are usually tried first, and surgery is generally reserved for more severe cases when symptoms do not improve or only improve temporarily.
According to the American Academy of Orthopaedic Surgeons, surgery may be considered when nonoperative treatment fails to provide lasting relief. During the procedure, the doctor cuts the ligament that is pressing on the median nerve to help resolve the symptoms.
Home remedies
Another way to help relieve symptoms is to apply a warm compress to the wrist for 10 minutes. After that, stretching exercises can be done by extending the arm and bending the wrist from side to side about 10 times.
At the end, a cold compress should be applied for another 10 minutes. This process can be repeated up to twice a day.